Friday, December 27, 2013

Quality vs Quantity: From Leather Boots to Weight Loss

There's a growing problem in our country.  It's a problem that afflicts most of the developed world.  It's the reason for which you have to replace your bedroom furniture every couple of years, processed food is cheaper than locally-sourced grub, and why you see the same crappy content all over the web whether it's on Facebook, Twitter, Reddit, or LinkedIn.  
Our society values quantity over quality.

Last weekend, I traveled to Fredericksburg with my lady, my mom, and my sister (three different people) to visit my late father's family for Christmas.  Virginia is loaded with antique shops, and there's a 50% chance that we'll stop if we pass one on the road.  When you walk through an antique shop with my mother, it's both frustrating and educational.  I simultaneously feel impatient and inspired by her elaborate description of "what to look for" in fancy china or quality woodworking.  My mother has had the advantage of being raised in the fifties and sixties when our society valued quality over quantity. Here is the problem: contemporary society has flipped a switch, and now we value quantity over quality.

George Ziermann (featured in the video above) has been making shoes for over forty years.  From watching the video, you can see that  he slaves over each and every pair of boots that he puts on his store shelves.  When a company says that they've been around for 150 years (see Frye boots), you are bound to get a good product, as they otherwise wouldn't have survived this long competing against cheaper alternatives.  Likewise, any rational human being would agree that hand-stitched, American-made pants are probably going to last longer than whatever junk you can buy at Wal-Mart.  

The Seasoned Pro Is a Dying Breed
I've got to take off on a tangent for a minute - hang tight.  My father was a unique man.  He was bored by engineering school, opting to drop out and join the navy where he learned how to fix aircraft.  After leaving the service, he started an HVAC company called Riley Mechanical right around the time he met my mom.  Over a few decades, he became the best in the city at diagnosing and fixing air conditioning and heating systems.  

On one occasion in my late teens, we were sitting in the main dining room of a local restaurant, and the owner came to our table to greet us.  He asked how our meal was, and my dad interrupted him, asking "Did you recently have some construction done on the property?" "Why yes, sir," the restauranteur replied, "Just last week."  "Ask the guys to check the orientation of the fuse in your main breaker.  Your air is circulating in the wrong direction." The restauranteur was baffled, "If you're right about this, Mr. Riley, you've got a new client."  Until the day he died, that business owner supplied my dad with more business than his small company could handle.  

There is something special about a true expert: they don't need to publicize.  Thirty years ago, when my dad was establishing his HVAC business, social media and the internet were merely an idea brewing in Al Gore's spunky young mind.  My dad's practice was built on word of mouth.  He provided a higher quality service than his competitors, and his clientele valued that.  They valued his approach in the same way that my mother values craftsmanship when examining tables in antique shops.  This is something that we're largely lacking in the marketplace today.

What Do HVAC Repairmen and Physicians Have in Common?
Up to this point, you're probably nodding along in agreement.  Now let's talk about healthcare.  In medical school, we learn diddly-squat about nutrition, exercise, stress management, and the importance of sleep.  There's simply too much to learn in medical school nowadays, and, unfortunately, a lot of what we learn defies clinical and anecdotal evidence.  

For example, you've probably heard that high cholesterol is a recipe for a heart attack.  Well, it turns that that's not exactly true, yet this misinformation is still supported by the American Heart Association despite a paucity of clinical evidence to support statin use in the prevention of heart attacks.  All cholesterol isn't the same, so to appreciate a patient's full risk of cardiovascular disease, you must take into account their comprehensive medical history and the various types of cholesterol present in the blood.   Instead, we are taught to order a basic lipid panel and treat with a statin if LDL is too high.  New cholesterol guidelines encourage physicians to prescribe statins faster than Willy Wonka pumps out gobstoppers.  This is dangerous because statins are critical in synthesizing important compounds in the body in addition to stabilizing cell membranes

As physicians, we are educated in fundamental biochemistry and physiology in order to make rationale decisions, but lifestyle modification isn't incentivized in medicine, so why bother studying extraneous materials?  The physicians that are willing to step back and take a look at our increasingly rates of obesity, diabetes, and cancer and ask "why?" are the George Ziermanns (from the video above) of healthcare.  If you are one of the few who splurge on quality clothing, boots, or furniture, ask yourself, "Why don't I adhere to this same philosophy in paying for services, especially those meant to keep me healthy?"  Taking the limitations of medical school into account, what if you found out that, in addition to attending medical school, there was a local doctor who dedicated a portion of their free time to reading medical literature and studying these topics as a function of longevity, health, and performance?  How would that sway your selection of a primary care physician?  

There's Both Too Much and Too Little Online
If you have been trying to lose weight, think about the question that I just posed.  Also, ask yourself why it's not working.  In the digital age, there's a plethora of advice on the internet and literally thousands of Twitter and Facebook accounts dedicated to posting pictures of ripped abs and inspirational messages.  There are an equal number of health coaches, physicians, dietitians, nutritionists, herbalists, yogis, boot camp instructors, etc. that all seem to have the answer.  So why haven't you found success in losing weight?

I'm doing my best to be rhetorical with these questions, because there isn't an easy answer.   Excess weight gain is a metabolic derangement.  Your problem is not that you are fat, lazy, and stupid.  If it were as simple as following a shopping list of "eat this, not that", you would have already lost the weight.  It's hard enough to find the motivation and courage to change your life around, yet, even if you already have the intrinsic motivation to pursue long-lasting lifestyle change, you may also find yourself stuck because, like a bogo sale at Wal-Mart, a lot of health-related services out there are crappy $20 jeans.  What you need is a hand-made pair of dungarees. 

This is where the trouble lies.  A click glance at Twitter will reveal that the majority of the nutrition and fitness content being circulated on the web is fluff, poorly-written, or downright wrong.  Over the past few weeks, I set out to un-follow any account on Twitter that was hell-bent on content marketing for the sake of attracting followers.  In all, I un-followed 789 accounts out of 933 (!!!), all of which were loaded with messages that contradicted themselves in addition to a lot of plain old horse crap about human physiology and biochemistry written by people that haven't done their homework.  This is a big problem, as it's damaging the potential for useful patient engagement by the physicians, dietitians, and fitness instructors that really care about this stuff.  

Poor Quality Is Becoming Ubiquitous
Another area where quantity is dominating quality is our food system.  Reading about biodynamic farming from Joel Salatin, listening to TED talks by Alan Savory, or attending a lecture by Diana Rodgers, you'll be exposed to some unusual ideas about the quality of food.  Their arguments are simple: quality must dominate over quantity if we ever want to break free from our dysfunctional food system.  If you're completely new to this ball game glance over some of my earlier posts, check out Robb Wolf's blog, read anything by Michael Pollan, look into the Weston A. Price Foundation, or simply Google the word "paleo".  The skinny is that our demand for cheaper, more convenient food sources has led to progressively poor quality plant and animals foods that are making us sick.  

Furthermore, in the same way that you can trust Frye to deliver high quality boots thanks to their 150 years of service, the paleo way of eating has been perfected by multiple millions of years by the ultimate product tester: natural selection.  So the gimmick diets you see popping up all over the interwebs?  They're probably junk, and I'd be wary of anybody pushing them on you.  (If you think this is nonsense, I am open to a phone call: 412-477-2142.  Seriously.)  

In no other sector of our society is our insistence on quantity for less dollars more pervasive than the modern food system.  You can vote with your dollar by joining a local food co-op, visiting local farms in person, or taking three minutes to Google "grassfed beef [insert the name of your town]".  I've given you a lot of options in this short paragraph!  But I are curious about weight loss.  Let's get back on track...

Real Pro vs Faux Pro
As a physician, dietitian, or health coach, if you want to have any meaningful impact in a patient or client's life, you need to take a step back once in a while and ask yourself, "Am I simply chasing the dollar by pandering to the digital world or am I putting out a quality product?"  If you're putting out multiple podcasts or blog posts every week, when are you finding time to work with patients or clients?  If you're blogging all day, when are you developing the experience required to develop weight loss or health care strategies for sick people?  If you just opened your practice, from what experience are you deriving the expertise required to write a well-researched book?  If you aren't putting out original ideas, you are saturating the web with junk.  Quit it.  Your content marketing is discouraging thousands of people who are failing to see positive results because they are being blasted daily with bad advice that you've promised will work.

The point I'm hoping to convey is that not every company out there is going to have the answer to your weight loss woes.  There's a huge difference between a health coach looking to get rich through content marketing and a health coach that rolls around restlessly at night because they can't seem to figure out the precise mechanism behind a particular client's weight loss plateau.  Likewise, that which sets apart a good mechanic from a bad mechanic is that the former is a student of their trade.  They offer comprehensive service to ensure that your HVAC system or Oldsmobile is running optimally.  

Mechanical repair not part of your vernacular?  How about Crossfit?  It's increasingly easy to become a certified Crossfit coach these days, but the certification printout on the wall doesn't necessarily translate into quality coaching.  The majority of Crossfit-certified trainers were simply gym-goers who were decent at doing the movements, so they coughed up money to Crossfit HQ to get a piece of paper.  Remember what happened when Michael Jordan took up coaching?  These trainers will be of no more help at transforming your body than the bro that swipes your fob upon entry to L.A. Fitness.  Don't get me wrong, I don't mean to rile any feathers in the Crossfit world.  I have gladly paid top dollar for help from Crossfit coaches who were true experts at biomechanics and personalized instruction.  Still, I urge you to apply the same criticism to fitness or health coaching as you apply when assessing food or furniture quality.  There are no quick fixes to your health.  It takes hard work from both you and your coach.  Don't be fooled by content marketing or gimmicks that suggest otherwise.

Value Quality When Purchasing a Product
Our country needs to look in the mirror and ask: "Where is my dollar going?"  When people say that "every purchase you make is a vote", heed their advice.  Everything that we see wrong with the world is secondary to rewarding greed and being unwise with our votes.  Unfortunately, we live in a world in which the resources that you require for survival are locked away, and you have to work your butt off in order to tap into those resources.  The mighty dollar is your ticket to attaining new stuff or useful services.  It's entirely your decision if you choose quality over quantity, but you get what you pay for.  

In today's digital world, quantity seems to be winning out over quality.  You as the consumer have the choice.  If you have been struggling with weight loss (or any other health problem for that matter) think about your specific needs.  It will only force us to become better coaches, physicians, or instructors if you, the consumer, demand a high quality product.  Think about the ideal health coach or physician with whom you want to work.  Whether you're buying a car, bookcase, or some quality time with an expert in nutrition/weight loss/olympic lifting/guitar it's the same decision: spend your money and time wisely.  

Find real experts with original ideas publishing thoughtful writing specific to your problems online.  If you really want a good product, invest your resources in a product created by somebody that is equally invested in helping you.  Find a health coach that is busy making and correcting mistakes in their management of clients' weight or health woes.  A cookie-cutter approach isn't going to work for you long-term.  You need a customized approach, and that takes time to develop.  Furthermore, a solid health coach isn't going to simply give you a shopping list or tell you which blood tests to request at your next doctor visit.  They're going to dig deep and suss out the true underlying problems.  That's what you are paying for; demand nothing less.

If you want to lose weight, you also need to have patience.  High quality food doesn't grow overnight.  Likewise, you can't expect to reach your weight loss goals overnight.  A quality health coach understands this. The right coach for you - the one that will truly help you lose weight - is someone that is diligently working to improve the quality of their product, which often times doesn't correspond with their number of followers on Twitter.  

Quality > > > quantity.

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD.  He can be reached at  You can also connect with him on Google+. 

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Tuesday, December 24, 2013

The Other Downside of Agriculture? Overpopulation.

I first read the book Ishmael on a beach in Cabarete, Dominican Republic.  My mom and sister laughed as I allowed the surf to wash over my lap.  They watched me turn the pages, enthralled with the words of Daniel Quinn, adjusting my position periodically only to protect the book from the rising tide water.  

Daniel Quinn's general message is that our subscription to humanity's cultural myth is going to lead to our extinction in the same way that it has been destroying hundreds of species across the planet.  
The myth goes a little like this: you go to school for twelve or more years, you find a job, buy a house, own a few cars, replace your TV every five years, etc.  We consume, our population grows, we make more stuff to feed this growing population, and the cycle continues.  

The basic premise for his protest of the way we live our lives is that the fundamental laws of ecology mandate a feedback system in which the population of a species increases when food is in abundance and decreases when food is scarce.  In our modern paradigm, the human population is destined to increase ad infinitum, so we must adjust our food production to sustain it.  By defying the laws of population ecology, we are consuming a great deal in order to sustain our burgeoning population while crowding out the rest of our ecosystem.  
With the switch to agriculture, not only did we adopt unhealthy eating habits, we also adopted a way of living that has permitted and continues to advocate for a rise in population that is slowly destroying the world and all of the organisms living here.

This topic is relevant for three reasons:
1) It's valuable to spread the doctrine of free thinkers with novel solutions to world problems
2) There is a better way for humans to live.  It has little to do with Crossfit and recovery drinks and everything to do with sustainable practices and a general respect for ecology 
3) Natural selection always wins: we're doomed if we don't curb consumption and overproduction

I have been exchanging emails for Mr. Quinn for a few months now.  I've had some questions and protests of my own, which he happily answered by email in addition to providing me with some of his materials and publications so that I could dig a little deeper.  Below, you'll find a speech that he made on Earth Day at Kent State University.  I'm reproducing it with his permission.  Enjoy.

Reaching for the Future with All Three Hands
Daniel Quinn, Kent State University, Earth Day, 1998

A few days ago I was feeling depressed and said to Rennie, my wife, "I don't see why I should give this speech at Kent State University. Why can't I talk about something that will send everyone home with warm, fuzzy feelings and smiles on their faces?"
            "Well, why don't you then?" Rennie said. "Why did you decide to speak on this subject in the first place?"
            "Because it's the most important subject in the world right now," I told her.
            "But why do you have to tackle it?"
            "Because no one else is tackling it, at least not for the general public."
            "Then I guess you're pretty well stuck, aren't you?"

I thought I'd start with this little story, just to let you know what I'm doing here.

The Phrygian sage Epictetus said: "Everything has two handles, one by which it can be carried and a second by which it cannot." The sage who stands before you here today says: "There's a third handle on the other side, but it can only be reached by people who realize they've got a third hand to reach with."
            I think the reason people invite me to speak at events like this is that they vaguely sense, from reading my books, that I have a third hand I use to grab at things that most people only use two hands on. They want to see what a three-handed man will make of whatever theme they're exploring—whether it's social investment, health care reform, or the future of business in the twenty-first century.
            Ours is an obsessively two-valued culture. For example, when it comes to games and sports, we have many that are two-sided (chess, checkers, tennis, boxing, football, baseball, soccer, basketball), some that are many-sided (poker, baccarat, track events, skiing events), but very few that are exactly three-sided.
            Our justice system is intrinsically two-valued. There must be prosecution and defense, plaintiff and respondent—one winner and one loser, always. Everyone HATES a hung jury, though it's generally perceived as a defeat for the prosecution and a win for the defense.
            Everyone takes it for granted that there are exactly two sides to every argument. When it comes to abortion, for example, there's the pro-choice side and the pro-life side, and people who haven't chosen one of these two sides don't represent a third side, they just don't represent any side at all. The same is true of issues like animal rights, capital punishment, and drug legalization.
            The media play an important role in shaping reality into two-sided events. Very often two-sidedness isn't clearly evident in developing situations. The fundamental news-gathering process helps to clarify—or manufacture—that desired two-sidedness. If one expert says that X is wonderful, the reporter is expected to find another expert who will say that X is terrible—or that Y is much more wonderful than X. This is, to a large extent, what makes the story NEWS.
            When it comes to "the environment," it hasn't been so easy to polarize the community. Where do you send a reporter to get a quote AGAINST clean water? Or AGAINST clean air? Obviously everybody wants clean water and clean air. The issue had to be recast into one that doesn't put everyone on the same side—and so it was. If  environmentalists are FOR the environment (as they very willingly say), then what are they AGAINST? The answer to that wasn't hard to find. If they're for the ENVIRONMENT, then they must against PEOPLE. This is kind of mind-boggling, but that's how it's shaken out. You can't be for people AND for the environment—you've got to "choose sides." This is an interesting example of taking a thing that originally presented only one handle and rotating it so as to expose two—thereby putting the third handle completely out of sight.
            The Arms Race between the United States and the Soviet Union started when I was ten years old, so I watched the whole race from beginning to end. I'm sure you all know how it went. We made an atomic bomb, they made one. We made a hydrogen bomb, they made one. We made an intercontinental ballistic missile, they made one. We pointed twenty missiles at them, they pointed thirty at us. We pointed a hundred at them, they pointed two hundred at us, and so on. It was a race with no finish line (except catastrophe). Apparently, it was a race no one could either win or quit.
            As you'd expect, the Arms Race presented two handles. You could take one of two positions. If you were a Hawk, you said Better Dead than Red, and if you were a Dove, you said Better Red than Dead, and every presidential candidate had to talk tough enough to placate the Hawks but also nice enough to placate the Doves.
            Then in the mid-60s there appeared a generation of children who wouldn't grab either of these handles. They were sick of the Arms Race, and they began groping for a third handle. In fact, they began to look like regular three-handed monsters. During the 1968 Democratic National Convention, Chicago police waged war on them, and the mayor felt completely justified in giving the order to "Shoot to Kill." A couple years later, as I'm sure you all know, more of the three-handed monsters staged a protest against the invasion of Cambodia right here at Kent State University. After National Guardsmen killed four of them, people began to understand just how dangerous these monsters were. When you saw people exhibiting signs of three-handedness, it was time to start shooting on sight.
            The youngsters of that generation vigorously campaigned for peace and against war, but they failed to find the third handle that would turn off the Cold War. That was found—and probably had to be found—by a Soviet leader, Mikhail Gorbachev, who said to us, in effect, "I'm going to do something really nasty to you. I'm going to deprive you of an enemy." He ended the Arms Race the only way such a race CAN be ended—by pulling out of it.

With the Cold War over, another problem came to the fore that was just as threatening: unchecked world population growth. The problem was not a new one. Thomas Malthus (1766-1834) had written: "The power of population is indefinitely greater than the power in the earth to produce subsistence for Man." Based on this, he most famously (and very influentially) predicted that we would eventually fail to be able to grow enough food to feed our growing population.
            What was new and most alarming in modern times was the realization that the increasing rate of our population growth was like nothing that could have been imagined in the age of Thomas Malthus. Modern research and modern surveys revealed that our population was doubling at an increasingly rapid rate, going from 1 billion to 2 billion in 123 years (1804-1927), from 2 billion to 4 billion in 48 years (1927-1975), and from 3 billion to 6 billion in just 39 years (1960-1999).
            Two handles on the problem (Population Growth) presented themselves. One of them was this:

As you see, this first handle comes with three mandates—three buttons you have to push to SLOW and ultimately END population growth.  We must (1) promote the adoption of effective, voluntary family planning; (2) advance the status of women; and (3) drastically improve social and economic conditions worldwide. THEN our population will AUTOMATICALLY level off and soon stop growing entirely. These first two mandates probably need no explaining; hey have wide support and are realized to a small degree every year, though probably not enough to account for any decrease in population growth. Here's the reasoning behind the third (and most ambitious) of these mandates:

It's an established fact that population growth has leveled off and even ceased in many socially and economically advanced nations. The United States and some European nations are examples. The citizens of these nations typically spend a lot of money on their children's health, education, and social well-bein g. Children are a welcome but heavy economic burden until near adulthood, and this condition discourages most parents from having large families. Contrast this with the world's least socially and economically advanced nations, where children, far from being economic burdens, typically begin to contribute to family income at a very early age (and very little money is spent on them). For this reason, having large families is actually an economic benefit, so it's no surprise that these nations have the world's highest rate of population growth; this can be halted by helping them attain the social and economic wealth of the most advanced nations.

On its face, this would seem to make sense, to be obvious. All we have to do is make all seven billion humans on the planet as wealthy as middle-class Americans and the problem of population growth will disappear. (As if such a thing could be accomplished with just a nod of our heads.) What is not quite so obvious is the fact that solving this problem creates another that is just as devastating.
            A United Nations Human Development Report of 1998 states that "Today’s consumption is undermining the environmental resource base. . . . Runaway growth in consumption in the  past 50 years is putting strains on the environment never before seen."
            To see how consumption presently stands (and to keep the math simple), let's pick an arbitrary number to designate the amount of all resources consumed by humans every year—100 billion megatons. As it presently stands (based on percentages from the Global Issues Web site), the world's 20% richest consume 76 billion megatons, the 20% poorest consume 2 billion megatons, and the middle 60% consume 42 billion megatons (100 billion megatons total, as you see). If all nations were to become as rich as the wealthiest 20%, then the 20% poorest would consume 74 MORE billion megatons than they do now, and the middle 60% would consume 54 MORE billion megatons than they do now, bringing the total to 204 billion megatons.
            In other words, if we somehow managed to push all three buttons on this handle, our population would stop growing, but its catastrophic impact on the environment would more than double. 

So much for the first handle on the population problem. The second handle was this:

To explain the rationale in detail:

We must increase food production to feed our growing population, not just this year but every year—for as along as our population keeps growing. (And without fail, our population DOES keep growing, year after year after year, and so we must increase food production year after year after year.)

Those who grasped this handle never asked WHY our population keeps growing. It just DOES. No other species on earth just keeps growing without limit—only the human. It's apparently the very nature of the human species to grow without limit—relentlessly, eternally, until the Malthus Disaster finally takes place. This is the plainest of all handles: We must increase food production to feed our growing population, for as long as that population keeps growing.
            But the underlying notion here that, out of all animate species on Earth, the human population alone just grows and grows without end FOR NO REASON is unacceptable. And if readers of Malthus had read more closely, they would have seen that it was unacceptable to him as well. He knew exactly why the human population grows. He wrote: "population does INVARIABLY increase WHEN THE MEANS OF SUBSISTENCE INCREASE."
            In other words, our population doesn't keep growing for no reason, it keeps growing because we keep increasing food production! If you'd like to see another statement of this law, here's how Peter Farb (1929-1980), noted anthropologist, linguist, ecologist, and biologist, put it in his book Humankind (1978):

In the interval from 10,000 to 6000 years ago—a mere 160 human generations—the population of the Near East is estimated to have increased from less than 100,000 to more than three million. With each increase, additional pressure was placed upon the food-producers to domesticate new species and to invent new technologies, such as those based on the plow and on irrigation. Human beings now found themselves on a treadmill from which to this day they have not been able to get off. They are still plagued by the basic paradox of food production: intensification of production to feed an increased population leads to a STILL GREATER INCREASE in population. [Emphasis mine.]

The very first time I came across this little-known but inescapably logical fact was in the 1969 Dunlop Illustrated Encyclopedia of Facts by Norris and Ross McWhirter. It can't hurt to have it said again. In their estimate,

The world has only fifteen generations before the human race breeds itself to an overcrowded extinction. . . . Increasing food production merely aggravates the problem by broadening the base of the expansion and hastening rather than postponing the end.

What the policy of increasing food production to feed our growing population has given us is an unwinnable Food Race that operates just the way the Cold War Arms Race did. In the Arms Race, every win on the U.S. side was answered by a win on the Soviet side, and every win on the Soviet side was answered by a win on the U.S. side, over and over again in self-perpetuation. In the Food Race, every win on the food production side is answered by a win on the population side, and every win on the population side is answered by a win on the food production side, over and over again in self-perpetuation. Far from postponing the Malthus Disaster, the Food Race is hastening it.
            The Arms Race could only be ended by someone reaching for the third handle: Walk away from the race. And that's the third handle by which the Food Race can (and must) be ended:

Only by ending the Food Race can we end the disastrous growth of our population.  
               It should be noted that, while it was widely deplored, the Arms Race gave great joy to the U.S. Military-Industrial Complex. They had a vested interest in the Cold War and would have been delighted to see the Arms Race continue forever. In the same way, the Food Race gives great joy to the Food Producing, Processing, and Distributing Complex. They have a vested interest in population growth and would be delighted to see the Food Race continue forever.
            There was a Mikhail Gorbachev to see to it that the Arms Race was abandoned. We have no such person to see to it that the Food Race is abandoned. You and I will have to do it—you and everyone else who cares about the human future on this planet.
            Tell everyone, print it on every surface: Constantly increasing food production doesn't AVERT disaster, it HASTENS it.
            If anyone tells you that we must increase food production to feed our starving millions, tell them that increasing food production has NEVER fed our starving millions. Year after year we go on increasing food production, and year after year the starving millions go on starving. Increasing food production doesn't REDUCE the number of people who are starving, it INCREASES that number, just the way it increases the number of blue-eyed people and the number of brown-eyed people, the number of right-handed people and the number of left-handed people,  the number of short people and the number of tall people.
            There are no starving rich people anywhere, no starving middle-class people, no starving lower-class people, no starving working-poor people. Only the poorest of the poor are starving—and that's not because there's no food. There's plenty of food, but they have no money to buy it. Producing food—no matter how much—puts no money in the pockets of the poor to buy the food they need to keep from starving. 

No other undertaking comes close to equaling the importance of ending the growth of our population, which at seven billion is causing the extinction of an estimated 50,000 species a year. Our food race is steadily and inexorably converting more and more of our planet's biomass into human mass. This is what happens when we clear a piece of land of wildlife and replant it with human crops. This land was supporting a biomass comprising thousands of species and millions of individuals. Now all the productivity of that land is being diverted into food that will be turned into human mass. Every day all over the world diversity is disappearing as more and more of our planet's biomass is being turned into human mass. This is what the Food Race is about. This is exactly what the Food Race is about: every year turning more of our planet's biomass into human mass.
            It has become my most important task to bring into view a third handle by which this problem can be carried: the unarguable fact that the Food Race can no more be won than the Arms Race could be won—and for the same reason: Neither race has a finish line, because every win made on the side of food is answered by a win on the side of population.
            The strange thing is that many people HATE hearing all this, yet I'm clearly pointing out a path of possibility and hope for humankind. I'm not a doom merchant, my compass is set firmly on success. Our population explosion is a problem we CAN get a handle on, provided we start reaching for it with that third hand.


For more information, start with these: Ishmael and My Ishmael.

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD.  He can be reached at  You can also connect with him on Google+. 

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Wednesday, December 18, 2013

Interview: Hensley Akiboh of S.W.A.G. Fitness

Have you ever walked into a nearly empty gym when your favorite jam comes on in your ear buds, and you think to yourself, "I'm going to go buck wild and bust a move on this treadmill right here!"  Maybe you have been a sweaty spectator during one of those crowded days where you see a brave soul jamming out on the treadmill doing a choreographed dance precisely for that machine followed by a twinge of envy. Let's just say I've been on either side of those scenarios. Music tends to allow me to lose myself to the point where I believe I'm a main character of 'Newsies' the musical. A jog with the right playlist can easily turn the illuminated streets into a stage. Ok. I've probably said too much... Last year, to my delight I was introduced to a fun and energetic man named Hensley Akiboh and his class: S.W.A.G. Fitness. During the first class I felt a bit lost with some of the choreography but lord knows I love to move to music. I was excited to be a part of such a large group of people in the dark studio, with a disco light flashing and the music blaring. There were people of all ages, shapes and sizes that attended. I once saw an entire family having a fun night of movement together!  From that first night I was hooked! It was a great feeling. I was permitted to step outside of my comfort zone and into an uneasy space of possibly making myself look foolish. This has become my church. Dancing has become my religion. You know the saying "Dance as if no one is watching"? Well, I prefer: “Dance first. Think later. It's the natural order.” ― Samuel Beckett
Without further ado, I'd like to introduce you all to my friend Hensley and his house of S.W.A.G.

When did you first get into dance?

Throughout most of my life, I had never been much of a formal dancer. I've never received any professional instruction and hardly ever took much of what's considered a "dance class" throughout most of college. I have, however, always been a social dancer. I love going out on weekends and dancing to great music. When did you start S.W.A.G.? S.W.A.G. Fitness was an idea sparked by a great friend of mine, Zaq Lawal, back in 2011. The idea came to him while he was working out in the gym one day. He enjoyed staying fit and healthy, liked lifting, but just did not enjoy what was available as far as cardio. Running on the treadmill, using the elliptical, biking....none of them were exercises he enjoyed doing. Having a background minoring in dance, a light bulb came on. When you dance, and you dance hard, you work up a pretty good sweat! Why not utilize something that people enjoy as a means of getting exercise?! S.W.A.G. Fitness (Sweating With A Goal) was born.
Who inspires you to continue to S.W.A.G.?
SWAG Fitness has been in full swing since March of 2012. I look forward to teaching class every Monday, Wednesday, and Friday. Who inspires me to continue teaching? The people who attend my class! I see people coming in week after week all because they say how much they love the class! When's the last time you saw so many high fives, smiles, and laughter in the gym!? There is so much positive energy in that studio, it can turn some of the worst days around and make them great days. I know you have several jobs, how would you describe the double life you lead? How do you balance them?
I actually have three jobs! I am a benefits consultant working for Aflac. I DJ weddings, parties, and events for Party-Time Productions. AND I teach S.W.A.G. Fitness at Pittsburgh Dance Center. It's a busy life, but it actually works out pretty well. During the day, I am working with business-owners and companies helping them with their employee benefits through Aflac. Monday, Wendesday, and Friday evenings, I teach S.W.A.G. Fitness. And I DJ on weekends! Rarely do I have a timing conflict, which is nice. Why do I do all three? The one thing all my jobs have in common is they each provide me with positive interactions with other people. With Aflac, I am helping small business owners and families protect themselves against the financial burden of an accident or illness. When I'm DJing, I'm usually celebrating with families on the happiest day of their life. And every time I get in front of a group of my SWAGsters, I get to share and enjoy what has really grown into a community of friends who all love my class! Where do you see dancing fitting into your life down the line?
I'm not too sure how dancing will fit into my life down the road. I have no intentions of leaving S.W.A.G Fitness anytime soon! I occasionally get the opportunity to share my class at various dance conventions and programs, which is always a lot of fun. Who knows? What would you tell people who have never taken your class before?
Don't be too nervous to try it. First of all, my class is only $5. What fitness class exists that only costs five bucks, no membership required?! If you're one of those "...but I can't dance" people, then this is perfect for you! The moves are easy, and it's a great way to have fun and dance your butt off to your favorite music! I don't claim to be a great dancer by any means, and neither will many people who regularly attend my class. By the end of my class, I only promise two things: 1) you'll be happy, and 2) you'll be sweaty!!  #SweatyHappyPeople #SWAGfam #SWAGFitness
Stephanie Telep is a co-founder and health coach at Sweat and Butter.  She received her training at the Institute for Integrative Nutrition and holds a bachelor’s degree in Psychology from Duquesne University.  She is inspired to help others make necessary changes in their lives while fostering a positive and healthy path. She can be reached at

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Thursday, December 12, 2013

In Defense of Your Crossfit "Cult"

I regularly hear the argument that "Crossfit is bound to fail".  As a coach at Crossfit Pittsburgh, I'm obviously not jumping on that band wagon anytime soon.  I think a more relevant question would be, why did Crossfit succeed as a company in the first place?

The answer is simple: Crossfit has been successful for many reasons that cults are successful.  In fact, if you are an avid Crossfitter, you've probably heard Crossfit compared to a cult at least once before.  Now...before you lose your temper, think about what a cult truly represents: community.  As one might find in a cult, the members of a Crossfit gym support the leaders, the leaders support the members, and the members support one another.  There is of course a financial contribution to help maintain upkeep of the physical environment of the "tribe", but financial obligations don't exist between members.  If you're not willing to play nicely, you are asked to leave.  The foundation of any successful lifestyle modification program is community, and Crossfit does this better than most.  
The tribe at Crossfit South Hills

The Evolution of Community

Our species evolved to support community, and the structure of our current society struggles to fulfill this genetic need.  It's difficult to argue with evolution. Everything that we see around us is the product of evolution, which is merely to say that things that work best persist while things that are less effective gradually fall by the wayside.  

For example, let's imagine that at one point in time the majority of people on earth didn't have fingers on their hands.  If suddenly somebody was born for whatever reason with fingers, this person would have a much high chance of survival than their compadres that lacked fingers. Longer survival leads to reproduction, and, if you don't survive to reproduce (i.e. raise children), your genes will die with you.  If, on the other hand, you are blessed with some trait (fingers, in this example) that confers a higher likelihood that you'll survive to reproduce, this trait will gradually become the new norm across your species.  Genetic mutation doesn't usually work this dramatically, but hopefully you get the point.  In reality, teeny weeny changes over billions of years and millions of generations ultimately resulted in the evolution of all species of biological organisms that we observe on the planet.  

When one trait (fingers) helps an organism survive over other members of its species (no fingers), this is known as natural selection.  Traits that help you survive to an age where you can reproduce will thus be selected for over others.  There are an infinite number of combinations of traits that have been tested over the ages, and the best combination is the one that remains at any given point in time in a specific environment.  This applies to physical attributes, cognitive abilities, and instincts.  If a tribe raises a child that refuses to work with others or share resources, that will mean the death of the tribe and its members, so natural selection also has shaped social dynamics.  This is important to understand. 

From community to cults...

"A few steps of the dance, performed just three or four days a month, 
enriched their lives greatly and took almost no effort.  As here on earth, 
the people of this planet were not a single people but many peoples, 
and as time went on, each people developed its own approach to the dance.  
Some continued to dance just a few steps three or four days a month.  Others 
found it made sense for them to have even more of their favorite foods, so they 
danced a few steps every second or third day.  Still others saw no reason why they 
shouldn't live mostly on their favorite foods, so they danced a few steps every single 
day.  Things went on this way for tens of thousands of years among the people 
of this planet, who thought of themselves as living in the hands of the gods."  
-Daniel Quinn, 'My Ishmael'

In his novels Ishmael and My Ishmael, Daniel Quinn discusses at length the evolution of the genetic need for community.  The process of evolution, which, as I've already discussed, was important ubiquitously in the development of all domains of our persons and culture, also selected for the way that we interact with one another.  

It's not difficult to imagine that early hunter gatherers operated in much the same way that modern apes organize themselves socially.  There was and often still is a hierarchy based on gender, sex, or age.  This hasn't changed.  What has changed is that now we live our lives for the purpose of acquiring resources that were available for free and in abundance prior to modern civilization.  In the past, basic necessities like food and water weren't locked up by a few.  But now, this simple concept separates us into two groups: the "haves" and the "have-nots".

We live in a system which forces us to work long hours to achieve basic financial stability.  If you observe the behaviors of hunter gatherer groups (or groups of lowland gorillas), there is no rush to acquire resources in order to achieve a worry-free future.  They are worry-free from day one.  Up until the dawn of modern civilization, which was a little over 10,000 years ago, we didn't have to worry about locking away resources for the future.  Resources abounded.  Nature was left intact, not fenced off on minimal reserves.  It wasn't sold at market.  Our food was a free resource.  

"But how else can you maintain a civil society?!!!  If everything was free, people would greedily just devour everything in their path!!!"  Are you sure?  This doesn't occur in modern day hunter gatherer groups.  It worked for our species until someone realized that if, instead of grazing casually on the resources that surround us they focused the majority of their waking hours on hoarding it and selling these resources, they could control the behavior of others in their tribe.  This led to sub-specialization of basic tasks in tribes of people so that others could hoard different resources and sell those.  What resulted was a system in which everybody had to work endlessly to keep up with the cycle in order to acquire basic resources...the same resources that modern apes, modern hunter gatherers, and our human predecessors collected for free in their environment.  

"Come on, DUDE!  We wouldn't have developed iPads had we not embraced our current societal structure!!"  Are you sure?  Granted, technologic advancement was slow 10,000 years ago, but early man was just as innovative as we are.  They simply had less on which to model their inventiveness.  Over time, information technology increases at a faster rate, which is described by the singularity curve below.  It's perfectly reasonable to assume that we would still have developed our contemporary technologies without creating a system that required us to forsake community.

Singularity curve

Rather than investing the majority of their waking hours working harder to accumulate more money to buy things while simultaneously destroying the delicate ecosystem that provides safe harbor to the resources that we need (clean water, nutritional food, and unpolluted air), these "primitives" were going along well-nourished and happy as can be, "progressing" as quickly as time permitted and resource availability necessitated.

What does this have to do with my health?

One thing that we can probably all agree on is that 99% of the people on our planet suffering from some degree of anxiety.  Our need for attention and belonging has led to excessive Youtube commenting, cell phone abuse, and social media psychopathy.  People would prefer to Instagram, Vine, or GoPro their lives instead of simply living them and enjoying the moment.  We all want to be embraced by our tribe, but we are too busy working to make money to buy the stuff we need, because the stuff that we need has been locked up and called "commodities".  

We were a true
community that day...
We crave this tribal sense of belonging.  I don't need data to back this up.  Evidence can be found at any large gathering of people.  Every Sunday millions of Americans dress up in NFL jerseys with the name of their favorite player emblazoned on the back.  Each summer, thousands of people show up at the National Furry Convention in Pittsburgh (not going any further in that explanation).  Star Wars.  Comicon.  City pride.  People holding up signs behind news anchors.  The feeling that we all had immediately after 911.  The layout of bars.  Political rallies.  Fitness programs that make you puke regularly.  Every. Single. Social. Movement. Throughout. History.

The lack of community required by our perpetual desire for more stuff has left us craving better connections.  Those of us without a real community are lonely.  The secret of our predecessors, which is still experienced by modern day hunter gatherers, was that they invested in people, not stuff.  Their primary currency was support for one another.  In our current society, those without financial success perish.  In hunter gatherer society, members of the tribe pay their dues by supporting others.  The same goes for alcoholism support groups, cults, places of worship, or simple nuclear families.  Would these groups be successful if not for some inherent desire for belonging?  It's in our genes thanks to natural selection, and we find that communities like those provided by Crossfit fill the void.    

For all of the reasons I've mentioned, it's no surprise that those communities that regularly produce a high yield of centenarians reportedly have extensive social ties.  Nor is it a surprise that cancer patients with support groups have a better chance of survival.  The world's centenarians are not the richest or most powerful, they simply live on what they've got, and they're happier, older, and healthier than the rest of us.  

Embrace It.

The takeaway here is that we should embrace community, not condemn it.  Our world would benefit if more time were invested in relationships and supporting our tribe mates than spending so much time in the rat race.  Journalist Emile Gauvreau summed this up nicely: "[We are] part of that strange race of people aptly described as spending their lives doing things they detest, to make money they don't want, to buy things they don't need, to impress people they don't like.”  After all, the attitude that more is better isn't making us healthier or happier.  

What does do the trick is finding a group of people that support you in order that you'll support them in return.   This explains the appeal of fantasy football leagues, yoga studio loyalty, cliques in middle school cafeterias, and the increasing popularity of your favorite barre class. The stronger your tribe, the happier and healthier you are.  This is what the Crossfit community has done right.  After they've picked their lungs up off the floor, Crossfit gym members will cap off their workout of the day (WOD) by planning a gym potluck, organizing shindigs at local bars, and making memories together.  Community is something we advocate for at Sweat and Butter.  It's possible to make incredible lifestyle changes on your own, but it's easier with the support of others.  This community can be comprised of friends, family, or Crossfit buddies.  The time invested in healthy relationships will outlast the new TV for which you've been moonlighting in order to afford.  That thing will be outdated in three weeks anyways!

Hopefully this piece provides some justification for why being involved in these ventures feels so good, leads to better goal-driven performance, and makes you happy.  It's because you belong.  Spend less time surfing your Facebook news feed, and get out there to spend time with your people.  Lastly, don't let haters bring you down about your new obsession with Crossfit or the new bikram studio that just opened up down the street.  They are just annoyed that you haven't invited them along...

Now, if you'll excuse me, I'm meeting a friend at the gym for a partner WOD.  Then we're meeting some friends for grub.  I can't wait!

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine.  He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD.  He can be reached at  You can also connect with him on Google+.

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